Wednesday, December 14, 2011

Cultural Differences

I'm a pretty accepting person. I value knowing people from different cultures, and try to be respectful of whatever needs or preferences they have.

If I know what they are, that is.

When my children were babies, I was a La Leche League Leader, and did a lot of home visits, helping new mothers learn how to breastfeed their babies. During my training to become a Leader, I learned about a number of possible cultural issues that might come up.  For example, there was one group that kept babies tightly swaddled, and another that would not take the child outside the home for at least the first six weeks.

In EMT classes, I don't think I've heard any specific cultural concerns addressed.  A little information about the possibility of a language barrier, but nothing about different cultural or religious practices.

A while back, we had an Amish patient. During the call, he did not answer questions I asked him, but freely answered questions asked by a male paramedic. It wasn't until after the call that I wondered if it was a cultural concern that created that situation- or whether he just didn't feel comfortable with me for some other reason.

I've asked a few people, and none of them knew.
I've done some research, but it's hard to know how accurate any of it is. There's nothing like a description of someone's beliefs by someone who doesn't agree with them.

The main thing I found is that there are different Amish groups, and they have different "rules" that they live by. Some have nothing to do with anything modern; others are more relaxed about it. For example, some have nothing to do with cars, but other groups might allow riding in cars, but not owning them.

The restrictions about vehicles might be important. I read one story about patients needing to be treated outside the ambulance because they would not go inside it.

Another interesting thing is that the Amish don't have insurance.
I would not withhold medical care from anyone lacking insurance, but I can imagine a situation where I'd be okay with them being transported by personal vehicle, assuming, of course, that they are allowed to do that.

The other thing I saw in various articles is that there is a likelihood of delayed calls for help in a community that does not have telephones in their houses. Hard to imagine, in this day and age, people not having nearly instantaneous availability of communication devices, but it's common in some areas.

I'm still looking for more information, and may have an opportunity to meet with some people and ask them what things would be particularly helpful for EMS providers to be aware of.

Until then, I'll keep looking online.

Here are a couple of websites that I found helpful:

Amish Culture and Healthcare (a nursing article)

Amish and Healthcare (A blog written by a former Amish woman)

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